Seven UMHS chronic disease programs receive prestigious Joint Commission certification

ANN ARBOR, MI – The Medical Management Center at the University of Michigan Health System now has seven programs that have received Disease-Specific Care Certification by The Joint Commission, the same accrediting body that examines and accredits hospitals to ensure safe and effective medical care.

2007 Gold SealThe disease-specific care programs undergo this rigorous review process every two years voluntarily, opening their programs’ policies, procedures and reports to external reviewers in order to validate their disease management goals toward helping patients develop a skill set for lifetime disease management. The Joint Commission interviews program leaders, physicians and other highly-trained clinicians, and patients in order to verify that disease-specific treatment plans adhere to evidence-based clinical care guidelines.

Throughout the summer, individual programs were examined and judged for best-practice patient care, disease-specific key indicators of outcomes of care, use of clinical practice guidelines and compliance with national standards, reports Rosemary Schuett, manager of the Center’s current array of disease management programs

The 2007-2008 certifications relate to programs for management of patients with:

* Pediatric Asthma
* Heart Failure
* Diabetes
* Depression
* Stroke
* Chronic Back Pain
* Lung Volume Reduction Surgery

For the Pediatric Asthma program, this is a first-time certification while the program was still in its first year of existence and is the only such program in Michigan to have earned this prestigious certification.

The Lung Volume Reduction Surgery program received first-time certification under the rigorous Advanced Certification process. It is the only certified LVRS program in Michigan, and one of only six certified by The Joint Commission nationwide.

The Primary Stroke Center program also received certification in the Advanced Certification category, which is only available for a small group of highly complex disease management programs.

Each Joint Commission-certified program must meet base certification requirements in five areas: delivering clinical care, performance measurement and improvement; supporting self-management, program management and clinical information management. Advanced certification typically involves complex, multi-disciplinary inpatient as well as outpatient care, with an examination of such things as standards for professional competency in highly-specialized procedures, standards for patient eligibility in the advanced program, specified medical and surgical procedures, the provision of intensive rehabilitation programs, and numerous quality measures.

“Preparation for this voluntary certification process is intense, but when I heard reviewers commenting on how comprehensive the programs are, the dedication of our care teams and the high satisfaction among patients, it validated the work our teams do every day to help patients improve self-care for their chronic illnesses,” says Schuett.

Brenda Hershmann, 47, is a ‘graduate’ of the LVRS program. Because of allergies and asthma, Hershmann was already struggling to breathe when she began smoking at age 21. Her condition steadily deteriorated over the years, even with supplemental oxygen, extensive medications and successfully giving up smoking.

Hershmann says surgery through the LVRS program improved her lung function by 52 percent.

“Before surgery, I was sent home from work regularly for being tired, and my supervisor told me I’d lose my job if I got pneumonia one more time,” Hershmann remembers.

Hershmann underwent a series of tests to assess the severity of her disease, including lung function testing, chest x-rays and CT scans. She was evaluated by a multidisciplinary team including a pulmonologist and general thoracic surgeon. Her health history was evaluated for presence of other major diseases, and she indicated her willingness to be involved in intensive post-surgery pulmonary rehabilitation. Successful smoking cessation was also a requirement. Hershmann was accepted into the program and had surgery in late 2006. In the surgery, some diseased portions of her lungs were removed: one-third of her right lung and one-fourth of her left lung.

Because she lives in rural Indiana, Hershmann’s pulmonary rehabilitation was done at home. She attributes her husband’s support and encouragement as the key to her success with completing exercise program her doctors assigned.

Today, Hershmann sees a dramatic difference in what she is able to achieve physically. She works as many as 18 hours a week overtime at a physically demanding factory job, and enjoys mowing her lawn twice a week with a manual mower, something she wasn’t able to do last year. And her coworkers have stopped treating her like a fragile doll, she says.

“I’m so glad I had the surgery. Now I get to ride my bike, chase the dog and keep up with my husband – we both like to dance,” Hershmann says.

The program that helped Hershmann is one of the more complex disease management programs at U-M. It offers a variety of interdisciplinary options and therapeutic approaches because so many patients can improve when treated with a non-surgical regimen of pulmonary rehabilitation, medications and weight reduction.

Only patients who have exhausted the other, less invasive options and can clearly benefit are considered for surgery. Still, the same physicians, nurses, cardio-pulmonary techs, dietitians, physical therapists and occupational therapists who coach non-surgical patients also coach the ones receiving surgical lung volume reduction so all patients can develop the skills for self-management of their medical condition.

“When disease management programs are accredited by The Joint Commission, patients know that a highly-reputed review agency has conducted an objective, structured and thorough examination. Examining and validating the goals, methods, processes and outcome improvements within these programs is assurance for patients that their quality of care meets the highest standards,” said Christopher Wise, Ph.D., director of Program Development and Outreach, Medical Management Center.

UMHS started building its disease management programs nine years ago as a natural extension of health care partnerships with Ford Motor Co. and General Motors Corp. The programs involve collaborative efforts with doctors, nurses and other clinical specialists, including individualized education and regular contact from a disease-specific clinical expert so that patients can learn to self-manage their condition, with the expertise of skilled practitioners to monitor and coach them along.

Written by Mary Beth Reilly